Effect Of Levetiracetam On Serum Levels Of Thyroid Hoymones In Epileptic Children

Background and objective: Endocrine and epilepsy are mutually affected in many ways. Hormonesinfluence the outset threshhold of epilepsy and the outset of epilepsy in turn affects the secretion of hor-mones. In addition, anti-epilepsy drugs have effect on endocrine. Especially study on thyroid hormonesattracted more and more attention. For adolescents who are in the key time of development and growth, thedeficiency of thyroid hormones may impact on the development of nervous system, resulting in severe de-velopmental disorder of brain which will affect the physical and mental development. Previously morestudies were made on the changes of thyroid hormones induced by traditional anti-epilespy drugs. However,levetiracetam（LEV）is a new type of anti-epilespy drug with a different mechanism from traditional oneand widely used in clinics as single medicine and add-on therapy with effective treatment and fewerside-effect. Up to now there is no relevant studies reported in its effect on the thyroid hormones in epilepsychildren. Because of the geographic and racial differences of the side–effects of drug, the current projectaims to provide the basis for rational medication of LEV in order to avoid its side effects on children’sgrowth, development, intelligence and reproduction which will improve the quality of the population byinvestigating the effect of LEV on the thyroid functions in epilepsy children in Henan Province in Chinaand analyzing the possible mechanism.Methods: The study was involved in40cases of children patients with epilepsy newly diagnosed inthe Department of Neurology, wards and outpatients of pediastrics in Dong-Jing Hopsital Affiliated to He-nan University collected from Mar.2010to Dec.2010. They were all medicated orally with LEV and car-bamazepine with minimal effective dose as low as possible. The serum levels of total T4, free T4, total T3and TSH were measured respectively to observe the effect of drugs in sixth and twelfth month after medi-cation.Results:1. The levels of TT4and FT4were significantly decreased respectively(P<0.05), comparedwith that before treatment by carbamazepine. However, the FT3level has a downward trend without statis-tical difference(P>0.05) in comparison with that before treatment by carbamazepine. TSH level has a up-ward trend without statistical difference(P>0.05) in comparison with that before treatment by car- bamazepine.2. The comparison of the hormone level after12month treatment by carbamazepine only withthat before treatment: The levels of serum TT4, FT4and TT3were all significantly decreased (P<0.05),compared with that before treatment by carbamazepine. The FT3level has a downward trend without sta-tistical difference(P>0.05) in comparison with that before treatment by carbamazepine. TSH level has aupward trend without statistical difference(P>0.05) in comparison with that before treatment by car-bamazepine.3. The comparison of the hormone level after12month treatment with that after6month oftreatment by carbamazepine only: The levels TT4and FT4had a downward trend respectively without sta-tistical difference(P>0.05). The levels TT3decreased slightly without statistical difference(P>0.05). Thelevel of FT3had no change after treatment for6and12months. TSH level increased slightly without sta-tistical difference(P>0.05).4. The comparison of the hormone level after6month treatment with that be-fore treatment by LEV only: The levels TT4increased slightly without statistical difference(P>0.05). Theserum levels of FT4and FT3had no change. The levels of TT3were all in normal range with no change atevery time point after treatment. TSH level increased slightly without statistical difference(P>0.05).5.The comparison of the hormone level after12month treatment with that before treatment by LEV only:The levels TT4increased slightly without statistical difference(P>0.05). The serum levels of FT4and FT3had no change. The levels of TT3were all in normal range with no change at every time point after treat-ment. TSH level increased slightly without statistical difference(P>0.05).6. The comparison of the hor-mone level after6month treatment with that after12month treatment by LEV only: The levels TT4in-creased slightly without statistical difference(P>0.05). The serum levels of FT4and FT3had no change.The levels of TT3were all in normal range with no change at every time point after treatment. TSH levelincreased slightly without statistical difference(P>0.05).7. Effect of treatment: The effective rate by LEVtreatment for6months was70%and was till as high as65%after12month treatment by LEV. No severeside effect was found during the treatment. No patient refused to be further treated due to side-effect.Conclusions:1. LEV could not induce the change of serum levels of thyroid hormones in pediastricpatients with epilepsy.2. TSH level could increase after6to12month treatment of such patients by LEV,but without statistical significance. It is important that the thyroid functions be periodically monitored inthe pediastric patient with epilepsy because they are in the crucial time of development and growth.3. LEVhas a confirmed effectiveness for the treatment of pediastric patients with epilepsy without obviousside-effects.